In the middle of a lake in the Eastern Democratic Republic, one of the most violent regions on earth, sits a tiny but mighty island called Idjwi. Here, my people have not only lived peacefully, isolated from the bloodshed surrounding them, but are also building a model
healthcare system.
The Eastern DRC has been ravaged by civil war for more than 15 years. A recent escalation of fighting between government forces and rebel groups spurred the United Nations to augment what is already the world's largest peacekeeping force. But Idjwi itself, while less than
50 miles (80 km) from some of the worst of the conflict, has remained a land apart - isolated from the violence, but also from advances in medical care, education and access to clean water.
Until 2010, there was only one hospital and four doctors on the southern tip of Idjwi, out of reach for the majority of the island's 250,000 people, who would have to travel up to eight hours to get there. Conditions were much the same as when I grew up in Idjwi in the 1970's. Mothers gave birth at home. Ten percent of children under five and 20 percent of nursing mothers were malnourished. Infections were left untreated. Three percent of the population was dying from preventable causes.
Today, that's no longer the case. Since my wife and I returned to open a clinic in northern Idjwi in 2009, we haven't recorded any maternal or child deaths. Four years ago 50 percent of people suffering from cholera would die; all 129 cases we treated for cholera survived. We
have been serving 150 children from more than 100 families in our nutrition program. The program, coupled with the introduction of "one garden per family", has decreased malnutrion in the two villages we serve; in fact, we haven't recorded any severe malnutrition cases in
the last eight months.
So how did Idjwi get here? My wife and I were both born and raised in DRC, but managed to leave the region during the terrible violence that tore through the Eastern DRC in the mid-1990s. I became a medical doctor and my wife became a registered nurse.
In 2002, we came to the United States with no possessions, no money, and no English, and eventually made a new life for ourselves in New York. But the pull of Idjwi is strong. We visited whenever we could afford to and treated patients for free. This helped, but the people of Idjwi needed more than occasional visits by a fly-in doctor.
A clinic was the first priority. On every trip to Idjwi, women asked me if we could build a safe place with a nurse where they could give birth. I knew that raising money to have outsiders build a medical facility wasn't the answer. There are too many competing demands from donors. If Idjwi was going to get a clinic, the community itself had to build it. At first, many people resisted, insisting that they didn't have the money. But I told them, "You have sticks, you have mud, you have labor, and you have each other." And so it started.
The next step was to identify members of their community to help lead. They were not traditional or government leaders. They were villagers, like Janvier Mugaru, a farmer, or Asha, a local beer trader, who had gained trust and respect organically--and they proved to be critical
to the completion of the project. When the money and resources ran out, these leaders went into the community, where 82 percent of the population live on less than $1 per day, and raised $1,500 to continue building and continue paying the nurse her $150 monthly salary. At this point, I knew the community was invested.
Today, we are expanding the clinic into a full-fledged hospital. More than 100 people have been working on the project, gaining new construction and technical skills and an income that is transforming their lives. Now, a place where no one could imagine setting up a hospital is a site for a 20,000-square-foot medical and community center that serves more than 25,000 patients every year (more than 10 percent of Idjwi's population), and employs 65 local workers. We also operate a community health worker program with more than two hundred trained volunteers who work within the community on health education and disease prevention. We operate a women's community group that meets twice weekly at our facility and focuses on health, economic, political and family issues that affect women; this group has hundreds of members. In addition we operate a successful farming program where we train community members to farm our land. We share the resulting food between volunteers and patients at our hospital.
Pregnant women, the elderly, pygmies (indigenous) and socially vulnerable members of the community receive free healthcare. Children pay 500 Congolese francs (50 cents) and adults 1000 Congolese francs (1US$). The new 50-bed hospital will be equipped with a range of equipment that will enable the hospital to provide quality and dignifying healthcare to people in Idjwi.
On Idjwi, where there is no central power plant and fuel deliveries are inconsistent, the best option for us is solar and wind. We are currently installing an 80 Kilowatt-hour solar power plant that will provide energy for basic operations. This energy is also powering the new satellite internet equipment we have installed, and that will allow us to use telemedicine.
We are already witnessing results from our approach; Venance, a 64-year-old father and grandfather, suffered from both cholera and malaria this year; "I knew I would die if the hospital wasn't close to where I live and if I had to pay," he told me in June. His treatment would have cost him 300 US$ elsewhere and could have led his family to a financial catastrophe. Now, Venance works at the hospital construction site as a carpenter and construction aide. Many other patients come from as far as the mainland to seek care at our hospital.
If this kind of community approach to health care, an indispensable one for sustainability, is possible on Idjwi -- one of the poorest, most difficult to reach areas in the world -- it's possible anywhere.